US10045781B2 - Closure lockout systems for surgical instruments - Google Patents

Closure lockout systems for surgical instruments Download PDF

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Publication number
US10045781B2
US10045781B2 US14/304,077 US201414304077A US10045781B2 US 10045781 B2 US10045781 B2 US 10045781B2 US 201414304077 A US201414304077 A US 201414304077A US 10045781 B2 US10045781 B2 US 10045781B2
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United States
Prior art keywords
anvil
staple cartridge
cartridge
end effector
elongate channel
Prior art date
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Active, expires
Application number
US14/304,077
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English (en)
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US20150359536A1 (en
Inventor
Michael S. Cropper
Michael E. Setser
Barry T. Jamison
Paul H. Kistler
John R. Dugan
Sudhir B. Patel
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Cilag GmbH International
Original Assignee
Ethicon LLC
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Priority to US14/304,077 priority Critical patent/US10045781B2/en
Assigned to ETHICON ENDO-SURGERY, INC. reassignment ETHICON ENDO-SURGERY, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: DUGAN, John R., CROPPER, MICHAEL S., JAMISON, BARRY T., PATEL, SUDHIR B., SETSER, MICHAEL E., KISTLER, PAUL H.
Priority to PCT/US2015/030935 priority patent/WO2015191231A1/en
Priority to JP2016572612A priority patent/JP6594910B2/ja
Priority to BR112016029080-1A priority patent/BR112016029080B1/pt
Priority to AU2015275140A priority patent/AU2015275140B2/en
Priority to MX2016016382A priority patent/MX2016016382A/es
Priority to RU2017100901A priority patent/RU2693364C2/ru
Priority to CN201580043190.8A priority patent/CN106572853B/zh
Priority to EP17202915.9A priority patent/EP3315081B1/en
Priority to EP15171897.0A priority patent/EP2954859B1/en
Priority to PL15171897T priority patent/PL2954859T3/pl
Publication of US20150359536A1 publication Critical patent/US20150359536A1/en
Assigned to ETHICON ENDO-SURGERY, LLC reassignment ETHICON ENDO-SURGERY, LLC ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: ETHICON ENDO-SURGERY, INC.
Assigned to ETHICON LLC reassignment ETHICON LLC CHANGE OF NAME (SEE DOCUMENT FOR DETAILS). Assignors: ETHICON ENDO-SURGERY, LLC
Priority to US16/058,427 priority patent/US10729441B2/en
Publication of US10045781B2 publication Critical patent/US10045781B2/en
Application granted granted Critical
Priority to US16/936,506 priority patent/US11547410B2/en
Assigned to CILAG GMBH INTERNATIONAL reassignment CILAG GMBH INTERNATIONAL ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: ETHICON LLC
Priority to US18/081,259 priority patent/US12070215B2/en
Priority to US18/627,631 priority patent/US20240245403A1/en
Active legal-status Critical Current
Adjusted expiration legal-status Critical

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
    • A61B17/105—Wound clamp magazines
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003—Steerable
    • A61B2017/00305—Constructional details of the flexible means
    • A61B2017/00309—Cut-outs or slits
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07257—Stapler heads characterised by its anvil
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07271—Stapler heads characterised by its cartridge
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2932—Transmission of forces to jaw members
    • A61B2017/2933—Transmission of forces to jaw members camming or guiding means
    • A61B2017/2936—Pins in guiding slots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
    • A61B2090/034—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself
    • A61B2090/035—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself preventing further rotation

Definitions

  • the present invention relates to surgical instruments and, in various embodiments, to surgical cutting and stapling instruments and staple cartridges therefor that are designed to cut and staple tissue.
  • FIG. 2 is an exploded assembly view of the surgical stapling instrument of FIG. 1 ;
  • FIG. 3 is an exploded assembly view of a portion of an articulation assembly embodiment
  • FIG. 5 is a side view of the handle with a handle case removed
  • FIG. 6 is a partial exploded perspective view of an end effector and anvil lock embodiment
  • FIG. 6A is a partial exploded perspective view of another end effector and anvil lock member embodiment
  • FIG. 7A is a perspective view of an anvil lock member embodiment of FIG. 6A ;
  • FIG. 10 is a bottom view of the end effector depicted in FIGS. 8 and 9 ;
  • FIG. 11 is a partial bottom perspective view of an anvil embodiment
  • FIG. 12 is a perspective view of a pivot mount embodiment
  • FIG. 14 is a perspective view of a proximal end portion of a surgical staple cartridge embodiment
  • FIG. 16 is a side view of an end effector embodiment prior to seating a staple cartridge in the elongate channel
  • FIG. 17 is a cross-sectional view of the end effector depicted in FIG. 16 ;
  • FIG. 18 is a side view of an end effector embodiment of FIGS. 16 and 17 with the anvil in the open position and wherein a surgical staple cartridge is being inserted into the elongate channel;
  • FIG. 19 is a cross-sectional view of the end effector of FIG. 18 ;
  • FIG. 20 is a side view of the end effector of FIGS. 16-19 with the staple cartridge embodiment seated within the elongate channel;
  • FIG. 22 is a side elevational view of the end effector of FIGS. 16-22 clamping tissue
  • FIG. 23 is a cross-sectional view of the end effector of FIG. 22 ;
  • FIG. 24 is a side elevational view of the end effector of FIGS. 16-23 in a fully clamped position ready to fire;
  • FIG. 25 is a cross-sectional view of the end effector of FIG. 24 ;
  • FIG. 26 is an exploded assembly view of another surgical stapling instrument embodiment
  • FIG. 27 is a perspective view of another pivot mount embodiment
  • FIG. 28 is a bottom perspective view of the pivot mount embodiment of FIG. 27 ;
  • FIG. 29 is a partial exploded perspective view of an end effector and another anvil lock member embodiment
  • FIG. 30 is a perspective view of another anvil lock member embodiment
  • FIG. 31 is a partial side elevational view of a proximal end portion of another surgical staple cartridge embodiment
  • FIG. 32 is a perspective view of a proximal end portion of the surgical staple cartridge embodiment of FIG. 31 ;
  • FIG. 33 is a side view of another end effector embodiment prior to seating a staple cartridge in the elongate channel;
  • FIG. 34 is a cross-sectional view of the end effector depicted in FIG. 33 ;
  • FIG. 35 is a side view of an end effector embodiment of FIGS. 33 and 34 with the anvil in the open position and wherein a surgical staple cartridge is being inserted into the elongate channel;
  • FIG. 36 is a cross-sectional view of the end effector of FIG. 35 ;
  • FIG. 37 is a side view of the end effector of FIGS. 33-36 with the staple cartridge embodiment seated within the elongate channel;
  • FIG. 38 is a cross-sectional view of the end effector of FIG. 37 ;
  • FIG. 39 is a side elevational view of the end effector of FIGS. 33-38 clamping tissue
  • FIG. 40 is a cross-sectional view of the end effector of FIG. 39 ;
  • FIG. 43 is a perspective view of an end effector including an anvil, a closure tube engageable with the anvil, an elongate channel, and a staple cartridge positioned in the elongate channel according to various embodiments of the present disclosure
  • FIG. 44 is a cross-sectional, perspective view of the end effector of FIG. 43 , illustrated with a cutting element and a wedge sled removed therefrom for the purposes of illustration;
  • FIG. 45 is an exploded perspective view of the end effector of FIG. 43 ;
  • FIG. 48 is an elevation view of the end effector of FIG. 43 depicting the anvil in an open orientation, an anvil lockout system, and the staple cartridge removed from the elongate channel, wherein the closure tube of the end effector has been illustrated in cross-section to illustrate various other aspects of the end effector;
  • FIG. 49 is a cross-sectional elevation view of the end effector of FIG. 43 in the configuration illustrated in FIG. 48 ;
  • FIG. 56 is a cross-sectional elevation view of the end effector of FIG. 43 in the configuration illustrated in FIG. 55 ;
  • FIG. 59 is an elevation view of the end effector of FIG. 43 illustrating the staple cartridge positioned in the elongate channel and the anvil in a fully clamped orientation, wherein the closure tube, depicted in cross-section, has been advanced distally to move the anvil into its fully clamped orientation;
  • FIG. 60 is a cross-sectional elevation view of the end effector of FIG. 43 in the configuration illustrated in FIG. 59 .
  • proximal and distal are used herein with reference to a clinician manipulating the handle portion of the surgical instrument.
  • proximal referring to the portion closest to the clinician and the term “distal” referring to the portion located away from the clinician.
  • distal referring to the portion located away from the clinician.
  • spatial terms such as “vertical”, “horizontal”, “up”, and “down” may be used herein with respect to the drawings.
  • surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.
  • the depicted surgical stapling device 10 includes a handle 20 that is operably connected to an implement portion 22 , the latter further comprising an elongate shaft assembly 30 that is operably coupled to an end effector 200 .
  • the handle 20 includes a pistol grip 24 toward which a closure trigger 152 is pivotally drawn by the clinician to cause clamping, or closing of an anvil 220 toward an elongate channel 210 of the end effector 200 .
  • a firing trigger 102 is farther outboard of the closure trigger 152 and is pivotally drawn by the clinician to cause the stapling and severing of clamped tissue in the end effector 200 .
  • closure trigger 152 is actuated first. Once the clinician is satisfied with the positioning of the end effector 200 , the clinician may draw back the closure trigger 152 to its fully closed, locked position proximate to the pistol grip 24 . Then, the firing trigger 102 is actuated. The firing trigger 102 springedly returns when the clinician removes pressure. A release button 120 when depressed on the proximal end of the handle 20 releases the locked closure trigger 152 .
  • a proximal end portion 153 of the proximal closure tube segment 151 is rotatably supported by the handle 20 to facilitate its selective rotation about the elongate axis A-A. See FIG. 1 .
  • a distal end portion 157 of the proximal closure tube segment 151 is coupled to a flexible neck assembly 70 .
  • the flexible neck assembly 70 has first and second flexible neck portions, 72 and 74 , which receive first and second elongate flexible transmission band assemblies 83 , 85 .
  • the first and second transmission band assemblies 83 , 85 have exterior reinforcement band portions 86 , 87 , respectively, extending distally from the structural portions of the bands.
  • Each exterior reinforcement band portion 86 , 87 has a plurality of attachment lugs 88 for securing first and second interior articulation bands 89 , 90 .
  • the transmission band assemblies 83 , 85 may be, for example, composed of a plastic, especially a glass fiber-reinforced amorphous polyamide, sold commercially under the trade name Grivory GV-6H by EMS-American Grilon.
  • the interior articulation bands 89 , 90 of the transmission band assemblies 83 , 85 be composed of a metal, advantageously full hard 301 stainless steel or its equivalent.
  • the attachment lugs 88 on the exterior reinforcement band portions 86 , 87 of the transmission bands 83 , 85 are received into and secured within a plurality of lug holes 91 on the corresponding interior articulation band 89 , 90 .
  • first and second connectors 92 , 93 At the distal end of the first and second interior articulation band assemblies 89 , 90 there are first and second connectors 92 , 93 .
  • the articulation assembly further comprises distal articulation bands 96 and 97 that are configured to hookingly engage the first and second connectors 92 , 93 , respectively.
  • the articulation bands 96 and 97 have receptacles 98 , 99 to couple the bands 96 , 97 to the end effector 200 as will be discussed in further detail below.
  • the flexible neck assembly 70 is preferably composed of a rigid thermoplastic polyurethane sold commercially as ISOPLAST grade 2510 by the Dow Chemical Company. As can be seen in FIG. 3 , the flexible neck assembly 70 has first and second flexible neck portions 72 , 74 . These neck portions 72 , 74 are separated by a central longitudinal rib 73 . See FIG. 6 . The neck portions 72 , 74 each have a plurality of neck ribs 75 configured essentially as semi-circular disks. The flexible neck portions 72 , 74 together generally form a cylindrical configuration.
  • a side slot 76 extends through each of the neck ribs 75 to provide a passage through the first and second flexible neck portions 72 , 74 for receiving the interior articulation bands 89 , 90 and exterior reinforcement band portions 86 , 87 of the flexible band assemblies 83 , 85 .
  • the central longitudinal rib 73 separating the first and second flexible neck portions 72 , 74 has a central longitudinal slot for providing a passage to receive the stapler actuating members.
  • first and second support guide surfaces 77 , 78 Extending proximally from the first and second flexible neck portions 72 , 74 are first and second support guide surfaces 77 , 78 for supporting the reciprocating movement of the interior articulation bands 89 , 90 and the exterior reinforcement portions 86 , 87 of the flexible transmission band assemblies 83 , 85 . Extending from the distal end of the flexible neck portions 72 , 74 is a channel guide 79 for guiding the movement of the stapler actuating members into a staple cartridge 300 of the end effector 200 as will be further discussed below.
  • an articulation assembly 62 Upon rotation of the articulation assembly 62 , one of the first and second flexible transmission band assemblies is moved forwardly and the other band assembly is moved rearwardly. In response to the reciprocating movement of the band assemblies 83 , 85 within the first and second flexible neck portions 72 , 74 of the flexible neck assembly 70 , the flexible neck assembly 70 bends to provide articulation.
  • an articulation assembly 62 includes an actuator 63 , an articulation body 64 and the nozzle 60 . Rotational movement of the actuator 63 causes corresponding rotation of the articulation body 64 within the nozzle 60 .
  • the first and second elongate transmission band assemblies 83 , 85 consequently reciprocate axially in opposite directions parallel to the longitudinal axis A-A of the endoscopic shaft 30 of the stapling device 10 to cause the remote articulation of the end effector 200 through the flexible neck assembly 70 .
  • the articulation body 64 further includes a drive gear 65 thereon.
  • the drive gear 65 has a flared opening 66 through it, and a lower pivot 67 .
  • there is a firing rod orifice 68 for receiving the firing rod 110 enabling the firing of staples into the clamped tissue in response to pivotal rotation of the firing trigger 102 .
  • the drive gear 65 is supported for meshing engagement with the first and second drive racks 94 , 95 on the flexible elongate transmission band assemblies 83 , 85 to effect the desired reciprocating movement of the band assemblies 83 , 85 .
  • the nozzle 60 of the articulation assembly 62 has a nozzle body 61 .
  • the nozzle body 61 has an axial bore 69 extending through it for receiving the drive gear 65 of the articulation body 64 .
  • the bore 69 provides a continuous opening axially from the frame into the elongate endoscopic shaft 30 and therefore the firing rod 110 and other operative components of the stapling device 10 can communicate with the end effector 200 .
  • Further details relating to the articulation assembly 62 may be found in U.S. Pat. No. 5,704,534, which has been previously herein incorporated by reference.
  • the end effector 200 comprises an elongate channel 210 that is configured to operably receive a surgical staple cartridge 300 .
  • An anvil 220 is movably supported relative to the elongate channel 210 and is moved from an open position ( FIGS. 16 and 17 ) to closed positions wherein tissue may be cut and stapled ( FIGS. 24 and 25 ).
  • the movement of the anvil 220 between open and closed positions is at least partially controlled by a closure system, generally designated as 150 , which, as indicated above, is controlled by the closure trigger 152 .
  • the closure system 150 includes the proximal closure tube segment 151 that operably houses the articulation band assemblies 83 , 85 in the manner discussed above and which is non-movably coupled to the flexible neck assembly 70 .
  • the proximal closure tube segment 151 includes a proximal end portion 153 that axially extends through the bore 69 in the nozzle 60 .
  • the proximal closure tube segment 151 has elongate axial slots 155 therethrough to permit the articulation body 64 to extend therethrough. See FIG. 2 .
  • the slots 155 enable the articulation body 64 to rotate about articulation axis B-B relative to the proximal closure tube segment 151 while facilitating the axial movement of the proximal closure tube segment 151 along axis A-A relative to articulation body 64 .
  • the transmission bands 83 , 85 function as a frame upon which the proximal closure tube segment 151 can axially move.
  • the proximal end 153 of the proximal closure tube segment 151 is rotatably coupled to a closure yoke 154 that is supported within the handle 20 for reciprocating motion therein. See FIGS. 4 and 5 .
  • the closure trigger 152 has a handle section 156 , a gear segment section 158 and an intermediate section 160 . See FIG. 5 .
  • a bore extends through the intermediate section 160 .
  • a cylindrical support member 162 extending from the second handle housing 23 passes through the bore for pivotably mounting the closure trigger 152 on the handle portion 20 .
  • a proximal end 98 of the closure yoke 154 has a gear rack 164 that is engaged by the gear segment section 158 of the closure trigger 152 .
  • the closure system 150 further includes a distal closure tube segment 170 that is non-movably coupled to the channel guide portion 79 of the flex neck assembly 70 by attachment tabs 72 , 74 . See FIGS. 9 and 10 .
  • the distal closure tube segment 170 has an opening 176 therein that is adapted to interface with an upstanding tab 224 formed on the anvil 220 as will be discussed in further detail below.
  • axial movement of the proximal closure tube segment 151 results in axial movement of the flex neck assembly 70 , as well as the distal closure tube segment 170 .
  • distal movement of the proximal closure tube segment 151 effects pivotal translation movement of the anvil 220 distally and toward the elongate channel 210 of the end effector 200 and proximal movement effects opening of the anvil 220 as will be discussed in further detail below.
  • the surgical instrument 10 further includes a firing system, generally designated as 100 , for applying firing motions to the firing rod 110 in response to actuation of the firing trigger 102 .
  • the firing system 100 further includes a drive member 104 that has first and second gear racks 105 , 106 thereon.
  • a first notch 109 is provided on the drive member 105 intermediate the first and second gear racks 105 , 106 .
  • a tooth 112 on the firing trigger 102 engages with the first notch 109 for returning the drive member 104 to its initial position after staple firing.
  • a second notch 114 is located at a proximal end of the firing rod 110 for locking the firing rod 110 to an upper latch arm 122 of the release button 120 in its unfired position.
  • the firing system 150 further includes first and second integral pinion gears 111 , 113 .
  • the first integral pinion gear 111 is engaged with a drive rack 115 provided on the firing rod 110 .
  • the second integral pinion gear 113 is engaged with the first gear rack 105 on the drive member 104 .
  • the first integral pinion gear 111 has a first diameter and the second integral pinion gear 113 has a second diameter which is smaller than the first diameter.
  • the firing trigger 102 is provided with a gear segment section 103 .
  • the gear segment section 103 engages the second gear rack 106 on the drive member 104 such that motion of the firing trigger 102 causes the drive member 104 to move back and forth between first and second drive positions.
  • the upper latch arm 122 on the release button 120 is engaged with the second notch 114 on the drive rack 115 such that the firing rod 110 is locked in its proximal-most position.
  • the upper latch arm 122 falls into a recess in the closure yoke, the upper latch arm 122 disengages with the second notch 114 to permit distal movement of the firing rod 110 .
  • the distal end 117 of the firing rod 110 is rotatably received within a firing bar mounting yoke 118 .
  • the firing bar mounting yoke 118 has a slot 119 for hookingly receiving a hook 132 formed on a proximal end of a knife bar 130 .
  • a support bar 140 is supported for axial movement between the first and second support guide surfaces 77 , 78 of the flex neck assembly 70 .
  • the support bar 140 has a slot 142 that is configured to permit the knife bar 130 to slidably pass therethrough.
  • the metal knife bar 130 has a tissue cutting edge 134 formed on its distal end and is configured to operably interface with a wedge sled operably supported within a surgical staple cartridge 300 .
  • an end effector 200 includes an elongate channel 210 that is configured to operably support a surgical staple cartridge 300 therein.
  • the elongate channel 210 has a proximal end portion that includes two spaced mounting tabs 212 that are configured to be engaged by the hooks 998 , 99 on the distal ends of the articulation bands 96 , 97 .
  • the reciprocating motions of the articulation bands 96 , 97 cause the elongate channel 210 to articulate relative to the flex neck assembly 70 .
  • the end effector 200 also includes an anvil 220 .
  • the anvil 220 is fabricated from, for example, 416 Stainless Steel Hardened and Tempered RC35 Min (or similar material) and has a staple-forming undersurface 222 thereon that is configured for confronting engagement with the staple cartridge 300 when mounted in the elongate channel 210 .
  • the anvil 220 is formed with a proximally extending mounting portion 223 that includes two trunnion walls 226 , 228 that each has a trunnion 30 protruding therefrom. See FIG. 11 .
  • a downwardly protruding pivot tab 234 that has a slot 236 extending therethrough that is configured to receive and support the knife bar 130 as it is axially advanced through the end effector 200 during cutting and stapling.
  • the anvil opening tab 224 is formed on the mounting portion 223 such that it can operably interface with the opening 176 in the distal closure tube segment 170 as will be further discussed below.
  • the anvil trunnions 230 are configured to be movably received in corresponding trunnion slots 214 formed in the proximal end of the elongate channel 210 .
  • Each trunnion slot 214 has an arcuate segment 216 that communicates with a locking notch 218 .
  • the body portion 262 of the anvil lock member 260 is further formed with two cam surfaces 263 configured to engage the proximal end surfaces 227 , 229 of the trunnion walls 226 , 228 .
  • the distal closure tube segment 170 ′ operates in the same manner as the distal closure tube segment 170 described above.
  • the surgical staple cartridge 300 includes a cartridge body 302 that may be fabricated from, for example, Vectra A435, 20% PTFE/15% GF-natural.
  • the cartridge body 302 is sized and shaped to be received within the elongate channel 210 .
  • the cartridge body 302 is configured to be seated in the elongate channel 210 such that is removably retained therein.
  • the cartridge body 302 may be formed with a centrally disposed slot 304 therein for receiving the knife bar 130 .
  • each side of the slot 304 there is provided rows 306 , 308 , 310 of staple openings 312 that are configured to support a surgical staple therein.
  • the surgical staples may be supported on staple drivers that are movably supported within the staple openings 312 .
  • Also supported within the staple cartridge body 302 is a wedge sled that is configured for axial movement through the cartridge body 302 when contacted by the cutting bar.
  • the wedge sled is configured with wedge-shaped driving members that contact the staple drivers and drive the drivers and their corresponding staples toward the closed anvil as the wedge sled is driven distally through the cartridge body 302 .
  • metal cartridge pans 314 , 316 may be attached to the cartridge body 302 as shown in FIGS. 14 and 15 .
  • the cartridge pans 314 and 316 serve to retain the wedge sled and drivers within the cartridge body 302 .
  • the cartridge body 302 additionally has at least one release member formed thereon that protrudes in the proximal direction.
  • two release members 320 are formed on the proximal end 319 of the cartridge 300 .
  • the release members 320 each have a wedge shape that defines a sloped pivot surface 321 that are configured to pivotally support a portion of the anvil mounting portion 223 thereon.
  • FIGS. 16 and 17 illustrate the position of the anvil 220 relative to the elongate channel 210 prior to installing a staple cartridge 300 .
  • the anvil lock member 260 When in that “unloaded” and open position, the anvil lock member 260 is biased in the distal direction by spring 269 such that the cam surfaces 263 on the anvil lock member 260 are in contact with the end surfaces 227 , 229 of the trunnion walls 226 , 228 .
  • the anvil lock member 260 pushes the anvil mounting portion 223 in the distal direction “DD” such that the trunnions 230 are seated in their respective locking notch 218 .
  • the cam surfaces 263 on the anvil lock member 260 in cooperation with the end wall surfaces 227 , 229 , also serve to pivot and retain the anvil in the open position as shown in FIGS. 16 and 17 .
  • the trunnion walls 226 , 228 are supported on the rocker surfaces 248 on the pivot mount 240 .
  • the surgeon cannot close the anvil 220 by actuating the closure trigger 152 to advance the distal closure tube 170 .
  • the closure trigger 152 cannot be actuated to its fully closed position whereby the firing trigger 102 may be actuated.
  • the end effector 200 may not be actuated.
  • FIGS. 18 and 19 illustrate the initial insertion of the staple cartridge 300 into the elongate channel 210 .
  • FIGS. 20 and 21 illustrate the end effector 200 after the staple cartridge 300 has been fully seated in the elongate channel 210 .
  • the release members 320 on the cartridge 300 engage the trunnion walls 226 , 228 and serve to move the anvil mounting portion 223 in a proximal direction “PD” such that the trunnion walls 226 , 228 now pivotally rest on the release members 320 .
  • PD proximal direction
  • the anvil mounting portion 223 has moved proximally such that the trunnions 230 are moved out of their respective locking notches 218 and into the bottom of the arcuate slot segment 216 into an “actuatable” position whereby the anvil 220 may be pivoted closed by actuating the closure trigger 152 .
  • both of the triggers 152 , 102 are forward and the anvil 220 has been moved to the actuatable position, such as would be typical after inserting the loaded end effector 200 through a trocar or other opening into a body cavity.
  • the instrument 10 is then manipulated by the clinician such that tissue “T” to be stapled and severed is positioned between the staple cartridge 300 and the anvil 200 , as depicted in FIGS. 22 and 23 .
  • movement of the closure trigger 152 toward the pistol grip 24 causes the proximal closure tube segment 151 , the flex neck assembly 70 and the distal closure tube segment 170 to move distally.
  • the distal closure tube segment 170 moves distally, it contacts a closure ledge 221 on the anvil 220 .
  • Pressure from the tissue captured between the anvil 220 and the staple cartridge 300 serves to move the anvil 220 such that the trunnions 230 are positioned to move within the arcuate trunnion slot segments 216 .
  • the surgeon may pivot the anvil 220 relative to the staple cartridge 300 to manipulate and capture the desired tissue “T” in the end effector 200 .
  • the anvil 220 is pivoted towards a clamped position. The retracted knife bar 130 does not impede the selective opening and closing of the anvil 220 .
  • the clinician moves the closure trigger 152 proximally until positioned directly adjacent to the pistol grip 24 , locking the handle 20 into the closed and clamped position.
  • the anvil trunnions 230 are located in the upper end of the arcuate slot portion 216 and the anvil tab 224 is received within the opening 176 in the distal closure tube segment 170 .
  • the clinician moves the firing trigger 102 proximally causing the knife bar 130 to move distally into the end effector 200 .
  • the knife bar 130 moves through the slot 236 in the pivot tab portion 234 of the anvil 220 and into the slot 304 in the cartridge body 302 to contact the wedge sled operably positioned within the staple cartridge 300 .
  • the knife bar 130 is driven distally, it cuts the tissue T and drives the wedge sled distally which causes the staples to be sequentially fired into forming contact with the staple-forming undersurface 222 of the anvil 220 .
  • the clinician continues moving the firing trigger 102 until brought proximal to the closure trigger 152 and pistol grip 24 . Thereby, all of the ends of the staples are bent over as a result of their engagement with the anvil 220 .
  • the cutting edge 132 has traversed completely through the tissue T.
  • the process is complete by releasing the firing trigger 102 and by then depressing the release button 120 while simultaneously squeezing the closure trigger 152 .
  • Such action results in the movement of the distal closure tube segment 170 in the proximal direction “D”.
  • As the anvil tab 224 is engaged by the opening 176 in the distal closure tube segment 170 it causes the anvil to pivot open.
  • the end surfaces 227 , 229 again contact the pusher surfaces 263 on the anvil lock member 260 to pivot the anvil to the open position shown in FIGS. 20 and 21 to enable the spent cartridge 300 to be removed from the elongate channel 210 .
  • an embodiment of an anvil lockout system 250 ′ includes an anvil lock member 400 that is configured to contact the anvil mounting portion 223 as will be discussed in further detail below.
  • the anvil lock member 400 comprises a leaf spring 402 that has a slot 404 therein for accommodating the knife bar 130 .
  • the leaf spring 402 is configured for attachment to the channel guide 79 ′′ of the flex neck assembly 70 ′′.
  • FIGS. 33 and 34 illustrate the position of the anvil 220 relative to the elongate channel 210 prior to installing a staple cartridge 300 ′.
  • the anvil lock member 400 When in that “unloaded” position, the anvil lock member 400 has engaged the upper surface of the anvil support portion 223 such that the anvil 220 is pivoted to the open position on the rocker surfaces 248 ′ on the pivot mount 140 ′.
  • the trunnions 230 are seated in their respective locking notch 218 .
  • the surgeon cannot close the anvil 220 by actuating the closure trigger 152 to advance the distal closure tube 170 ′.
  • closure trigger 152 cannot be actuated to its fully closed position whereby the firing trigger 102 may be actuated. Thus, when no cartridge 300 ′ is present, the end effector 200 may not be actuated.
  • FIGS. 35 and 36 illustrate the initial insertion of the staple cartridge 300 ′ into the elongate channel 210 .
  • FIGS. 37 and 38 illustrate the end effector 200 after the staple cartridge 300 ′ has been fully seated in the elongate channel 210 .
  • the proximal end portion 303 on the cartridge 300 ′ engages the trunnion walls 226 , 228 and serves to move the anvil mounting portion 223 in a proximal direction “PD” such that the trunnions are moved out of their respective locking notch 218 and into an actuatable position the bottom of the arcuate slot segment 216 .
  • the anvil 220 is now in position to be pivoted closed by actuating the closure trigger 152 .
  • both of the triggers 152 , 102 are forward and the anvil 220 is open and in the actuatable position, such as would be typical after inserting the loaded end effector 200 through a trocar or other opening into a body cavity.
  • the instrument 10 ′ is then manipulated by the clinician such that tissue “T” to be stapled and severed is positioned between the staple cartridge 300 ′ and the anvil 220 , as depicted in FIGS. 39 and 40 .
  • the closure trigger 152 toward the pistol grip 24 causes the proximal closure tube segment 151 , the flex neck assembly 70 ′′ and the distal closure tube segment 170 ′′ to move distally.
  • the distal closure tube segment 170 ′ moves distally, it contacts a closure ledge 221 on the anvil 220 .
  • Pressure from the tissue captured between the anvil 220 and the staple cartridge 300 ′ serves to move the anvil 220 such that the trunnions 230 are positioned to move within the arcuate trunnion slot segments 216 .
  • the surgeon may pivot the anvil 220 relative to the staple cartridge to manipulate and capture the desired tissue “T” in the end effector 200 .
  • the anvil 220 is pivoted towards a clamped position.
  • the retracted knife bar 130 does not impede the selective opening and closing of the anvil 220 .
  • the clinician moves the closure trigger 152 proximally until positioned directly adjacent to the pistol grip 24 , locking the handle 20 into the closed and clamped position.
  • the anvil trunnions 230 are located in the upper end of the arcuate slot portion 216 and the anvil tab 224 is received within the opening 176 in the distal closure tube segment 170 ′′.
  • the clinician moves the firing trigger 102 proximally causing the knife bar 130 to move distally into the end effector 200 .
  • the process is complete by releasing the firing trigger 102 and by then depressing the release button 120 while simultaneously squeezing the closure trigger 152 .
  • Such action results in the movement of the distal closure tube segment 170 ′′ in the proximal direction “D”.
  • the anvil lock member 400 applies a biasing force to the upper surface of the trunnion walls of the anvil mounting portion 223 and serves to pivot the anvil to the open position shown in FIGS. 33 and 34 to enable the spent cartridge 300 ′ to be removed from the elongate channel 210 .
  • distal movement of the proximal closure tube segment 1151 can generate translational movement of the anvil 1220 distally and rotational movement toward the elongate channel 1210 of the end effector 1200 , for example.
  • proximal movement of the proximal closure tube segment 1151 can generate translational movement of the anvil 1220 proximally and rotational movement away from the elongate channel 1210 of the end effector 1200 , for example
  • the surgical staple cartridge 1300 can be structured and configured to interact with the anvil lockout system 1250 and the shiftable guide 1240 , for example, when the staple cartridge 1300 is installed in the elongate channel 1210 .
  • the surgical staple cartridge 1300 can include a cartridge body 1302 , which can be similar to cartridge body 302 , for example.
  • the cartridge body 1302 can be sized and structured to be received within the elongate channel 1210 .
  • the cartridge body 1302 can be configured to be seated in the elongate channel 1210 such that the cartridge body 1302 is removably retained therein.
  • FIGS. 52-60 depict the staple cartridge 1300 fully seated within the elongate channel 1210 .
  • the proximal nose portion 1320 of the cartridge 1300 can be nested within the recess 1238 ( FIG. 54 ) in the shiftable guide 1240 .
  • the tapered nose portion 1320 can slide into the recess 1238 in the shiftable guide 1240 until the cartridge body 1302 is in abutting engagement with the shiftable guide 1240 .
  • the tapered nose portion 1320 can push the shiftable guide 1240 in the proximal direction “PD”, for example.
  • a portion of the shiftable guide 1240 can be in abutting engagement with a portion of the proximally extending mounting portion 1223 of the anvil 1220 .
  • the proximal end and abutment surface 1248 of the barrier wall 1241 of the shiftable guide 1240 can be positioned against a contoured edge 1225 of the trunnion wall 1226 , 1228 .
  • proximal shifting of the shiftable guide 1240 can also affect proximal shifting of the trunnion walls 1226 , 1228 of the mounting portion 1223 .
  • the distal closure tube segment 1170 can contact the closure ledge 1221 on the anvil 1220 .
  • the anvil 1220 can contact the tissue and push the tissue against the staple cartridge 1300 to create clamping pressure within the tissue.
  • different types of tissue can react differently to the clamping pressure applied thereto; nonetheless, the tissue can apply a reactive force to the anvil 1220 which can cause the anvil 1220 to move along a path which is at least partially defined by the arcuate trunnion slot segments 1216 .
  • the surgeon can pivot the anvil 1220 relative to the staple cartridge 1300 to manipulate and capture the desired tissue in the end effector 1200 .
  • the clinician can move the closure trigger 152 (see, e.g., FIGS. 1 and 2 ) proximally until positioned directly adjacent to the pistol grip 24 (see, e.g., FIGS. 1 and 2 ), for example, locking the handle 20 (see, e.g., FIGS. 1 and 2 ) into the closed and clamped position.
  • the anvil 1220 is in its fully clamped position, referring now to FIGS. 59 and 60 , the anvil trunnions 1230 can be located in the upper end of the arcuate slot portions 1216 .

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
US14/304,077 2014-06-13 2014-06-13 Closure lockout systems for surgical instruments Active 2036-07-12 US10045781B2 (en)

Priority Applications (15)

Application Number Priority Date Filing Date Title
US14/304,077 US10045781B2 (en) 2014-06-13 2014-06-13 Closure lockout systems for surgical instruments
PCT/US2015/030935 WO2015191231A1 (en) 2014-06-13 2015-05-15 Closure lockout systems for surgical instruments
JP2016572612A JP6594910B2 (ja) 2014-06-13 2015-05-15 外科用器具用のクロージャロックアウトシステム
BR112016029080-1A BR112016029080B1 (pt) 2014-06-13 2015-05-15 Conjunto de instrumento de grampeamento
AU2015275140A AU2015275140B2 (en) 2014-06-13 2015-05-15 Closure lockout systems for surgical instruments
MX2016016382A MX2016016382A (es) 2014-06-13 2015-05-15 Sistemas de bloqueo de cierre para instrumentos quirurgicos.
RU2017100901A RU2693364C2 (ru) 2014-06-13 2015-05-15 Закрывающие системы блокировки хирургических инструментов
CN201580043190.8A CN106572853B (zh) 2014-06-13 2015-05-15 用于外科器械的闭合锁定系统
EP15171897.0A EP2954859B1 (en) 2014-06-13 2015-06-12 Closure lockout systems for surgical instruments
PL15171897T PL2954859T3 (pl) 2014-06-13 2015-06-12 Układy blokady zamknięcia do narzędzi chirurgicznych
EP17202915.9A EP3315081B1 (en) 2014-06-13 2015-06-12 Closure lockout systems for surgical instruments
US16/058,427 US10729441B2 (en) 2014-06-13 2018-08-08 Closure lockout systems for surgical instruments
US16/936,506 US11547410B2 (en) 2014-06-13 2020-07-23 Closure lockout systems for surgical instruments
US18/081,259 US12070215B2 (en) 2014-06-13 2022-12-14 Closure lockout systems for surgical instruments
US18/627,631 US20240245403A1 (en) 2014-06-13 2024-04-05 Closure lockout systems for surgical instruments

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US14/304,077 US10045781B2 (en) 2014-06-13 2014-06-13 Closure lockout systems for surgical instruments

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US10045781B2 true US10045781B2 (en) 2018-08-14

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US14/304,077 Active 2036-07-12 US10045781B2 (en) 2014-06-13 2014-06-13 Closure lockout systems for surgical instruments
US16/058,427 Active 2034-11-13 US10729441B2 (en) 2014-06-13 2018-08-08 Closure lockout systems for surgical instruments
US16/936,506 Active 2034-12-25 US11547410B2 (en) 2014-06-13 2020-07-23 Closure lockout systems for surgical instruments
US18/081,259 Active US12070215B2 (en) 2014-06-13 2022-12-14 Closure lockout systems for surgical instruments
US18/627,631 Pending US20240245403A1 (en) 2014-06-13 2024-04-05 Closure lockout systems for surgical instruments

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US16/058,427 Active 2034-11-13 US10729441B2 (en) 2014-06-13 2018-08-08 Closure lockout systems for surgical instruments
US16/936,506 Active 2034-12-25 US11547410B2 (en) 2014-06-13 2020-07-23 Closure lockout systems for surgical instruments
US18/081,259 Active US12070215B2 (en) 2014-06-13 2022-12-14 Closure lockout systems for surgical instruments
US18/627,631 Pending US20240245403A1 (en) 2014-06-13 2024-04-05 Closure lockout systems for surgical instruments

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US (5) US10045781B2 (zh)
EP (2) EP2954859B1 (zh)
JP (1) JP6594910B2 (zh)
CN (1) CN106572853B (zh)
AU (1) AU2015275140B2 (zh)
BR (1) BR112016029080B1 (zh)
MX (1) MX2016016382A (zh)
PL (1) PL2954859T3 (zh)
RU (1) RU2693364C2 (zh)
WO (1) WO2015191231A1 (zh)

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BR112016029080B1 (pt) 2022-12-20
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JP6594910B2 (ja) 2019-10-23
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US20210007743A1 (en) 2021-01-14
CN106572853B (zh) 2019-11-19
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RU2017100901A (ru) 2018-07-16
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BR112016029080A2 (pt) 2017-08-22
US10729441B2 (en) 2020-08-04
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PL2954859T3 (pl) 2018-04-30
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